I waited my entire life to be Dr. Jeremy Faust and to write my first orders as an M.D.
On the way to my very first shift in the emergency department this past July, I was tweeting back and forth with several emergency physicians, wondering aloud what my first case as resident might be.
My friend, Dr. Seth Trueger, Tweeted that his first patient was a guy with a Bic pen coming out of his neck (no, it was not an attempted airway). How could I top that? Fate would have to be on my side. Well, it wasn’t.
After 4 years of college, followed by graduate school and then medical school, my first orders as a bona fide M.D. were for … wait for it … ibuprofen, a drug I could buy at a pharmacy at age 14. But until that day, I could not legally order it in a hospital. And just to add some spice to my humble pie, the nurse then asked if I could write for Maalox because the patient had not eaten in a while, and she found this to be helpful in such cases.
It was hardly procainamide for a Wolff-Parkinson-White arrhythmia or some other exciting order. As it turned out, my first patient was unremarkable. And in fact, what I most remember was my attempt simply to establish myself as my patient’s doctor. Literally, I tripped up on the first sentence. “Hi, I’m Jeremy. Uh…um, I’m Doctor Faust.” I just could not get the words out. It felt wrong to say, even though I had already become accustomed to my friends and family jokingly calling me doctor.
A doctor, I thought, is someone who knows everything. I may know something, but now that I have officially become a doctor, I feel like more of a “half” doctor.
I now realize that the real doctors are the attendings. And who knows, maybe when I become an attending, I will think that the real doctors are the illustrious living legends among us who have been at this for decades. Maybe in turn, they revere luminaries long gone.
Maybe, ultimately, the word doctor is more of an ideal to strive toward rather than just a bestowed title.
In light of this, and the sense that the doctor-patient relationship has changed from the days of “doctor’s orders” from on high, I and many of my resident colleagues often default to introducing ourselves by our first names, not our well-earned title: Doctor. Inviting patients to be on a first-name basis with us seems friendlier, more approachable, and less egotistical. And it perhaps lengthens our waning days as “young” adults.